During much of my medical career, my understanding of the human bladder was that it was a reservoir for the body’s metabolic waste and that it simply stores #urine until it signals a sense of fullness to motivate volitional voiding. As filling increases tissue distension, intensity of desire to void increases accordingly. Throughout most of the day, the bladder just passively fills. How reassuringly simple! I also understood that bladders, and mostly of females, are very vu

For some reason, we long assumed that #bacteria in the extra-systemic, #urinary cavity are subject to the same conditions as in other tissue infections, but they aren’t. #Antibiotics get to other tissue infections via blood whereas #cystitis #pathogens encounter antibiotics in #urine. That’s a big difference, first of all, blood pH range is narrow, so an antibiotic’s MIC (minimum inhibitory concentration) is predictable there. The urinary pH range is very wide. Antibiotic MIC